Avery Young

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11678 Issued in TX

Practice address

911 23Rd St
Canyon, TX 79015-4645

Phone

(806) 655-2104

NPI assigned

Mar 15, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut East Texas Urgent Care Centers, PLLCGroup PAC ID 7517385388, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ayoung1336123@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut East Texas Urgent Care Centers, PLLC

  • Urgent Care Clinic/Center
  • Canton, TX
  • NPI 1356974281
  Medicare reassignment Care Compare group
• Next Level MV LLC

  • Urgent Care Clinic/Center
  • Pearland, TX
  • NPI 1013432285
  Medicare reassignment NPD
• Nluc PLLC

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1518209113
  Medicare reassignment
• Nluc PLLC

  dba Next Level Urgent Care-League City

  • Urgent Care Clinic/Center
  • League City, TX
  • NPI 1043814049
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1700389715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791050201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 23RD ST",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154645",
            "telephone_number": "806-655-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AVERY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Leroy Wilson, D.D.S.
• Winfrey Enterprises, LLC (Canyon Physical Therapy)
• Jennifer Marie Winfrey, P.T.
• Felicia Irena Winn, PHARMD
• Jaclyn Glenell Wood, ATC, LAT
• Leigh Ann Youso

• Physician Assistant in Canyon, TX
• Providers in Canyon, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.